Becker’s Healthcare Podcast Medicare Advantage Shakeup: UnitedHealth Struggles, Humana Holds Strong
Jul 30, 2025
Jacob Emerson, Associate News Director at Becker’s Healthcare and expert in payer market trends, joins to discuss the shifting landscape of Medicare Advantage. They delve into Humana's impressive earnings of $545 million and strategic membership reductions, positioning it well against competitors. In contrast, UnitedHealth grapples with rising costs and leadership turnover, raising concerns about its future. The discussion highlights how these dynamics affect the health insurance market and shape the outlook for 2025.
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Humana's Strategic Focus Pays Off
- Humana is nearly exclusively focused on Medicare Advantage with some Medicaid business.
- They improved profitability by exiting unprofitable markets and updating guidance positively for 2025.
UnitedHealth's Broad Struggles Revealed
- UnitedHealth faces major internal challenges across all divisions including Medicare Advantage and Optum.
- They underestimated care costs, particularly due to new CMS risk adjustment changes and complex patient needs.
Complexity and Leadership Impact
- UnitedHealth’s complexity with thousands of subsidiaries makes running the business and knowing risks difficult.
- Leadership changes add to challenges, emphasizing the importance of strong leadership for huge enterprises.